Complex Care
Complex Care Integrated Program
People with complex care needs are admitted to the program when their care needs should be addressed in a multidisciplinary hospital setting. Complex care patients often need highly-skilled, technology-based care.
There are four current program streams in the Complex Care Integrated Program:
|
Short-Term Complex Medical Management |
|
People identified for this type of care are those who require close medical monitoring with access to scheduled physician care and/or daily medical oversight. On admission they may have limited physical and/or cognitive capacity due to medical complexity but believed to have restorative potential. The multidisciplinary management of their care needs may include any of the following requirements:
|
|
Activation and Restoration |
|
People identified for this type of care need exercise and recreational activities to increase strength and independence. Discharge destination is to return to their pre-admission location. These patients are medically stable and are able to participate cognitively and physically in restorative activities. Patients require only weekly physician access and/or follow up. The therapeutic services are consulted by a Regulated Health Professional and include group sessions and one-on-one. |
|
Low Intensity Rehabilitation |
|
People identified for this type of care require a time-limited, coordinated inter-professional plan of care to achieve their maximum level of functioning following an acute episode or following an unexpected/unexplained de-compensation. Prior to admission a tentative discharge plan will be established as a goal for their rehabilitation. People must be ready to participate in an active reactivation program. They should demonstrate potential for improvement as assessed by the multidisciplinary team through a slow paced program. The therapeutic services include:
Other therapeutic services may include:
|
|
Palliative Care |
|
People in this stream of care will require short term management of the end-stage of their illness. The focus of palliative care is to enhance the quality of life for those who are dying, taking into account their physical, spiritual, psycho-social and cultural needs. Their stay in the hospital is for medical intervention and 24 hour nursing care to achieve pain and/or symptom control. |
Regardless of the program, you will receive excellent care and appropriate rehabilitation and therapy services.
Family Conferences
Regular patient care conferences are held. The family and the patient are invited along with representatives from each discipline. The team discusses the patient's progress and suggestions or changes that may be made. Having all the disciplines available in one room is a great help when it comes to making important .